Risk factors for osteoporosis are common in young and middle-aged patients with femoral neck fractures regardless of trauma mechanism

Abstract

Background and purpose There have been few prospective studies examining young and middle-aged patients with hip fracture. We therefore investigated background data, risk factors, and the trauma mechanism in young and middle-aged patients with femoral neck fracture.Patients and methods 185 patients, 27 young (20–49 years old) and 158 middle-aged (50–69 years old) were prospectively included in a multicenter study lasting 3 years. Background data and risk factors for osteoporosis and fracture were obtained, and the type of injury was classified as low-energy trauma, high-energy trauma, or sports injury.Results In the young age group, the fracture occurred because of low-energy trauma in two-fifths of patients and because of sport injury in two-fifths of patients. The rest occurred because of high-energy trauma. The corresponding proportions for the middle-aged group were four-fifths, one tenth, and one tenth (p < 0.001). There was a higher proportion of men (19/27) in the young group than in the middle-aged group (69/158) (p = 0.001). One fifth of the young patients were smokers as compared to two-fifths in the middle-age group (p = 0.04). One quarter of the patients reported high-volume alcohol drinking, with no difference between the two groups. Furthermore, three-quarters of the young patients and four-fifths of the middle-aged patients had one or more risk factors for osteoporosis and fracture.Interpretation A minority of patients in each age group had high-energy trauma as the cause of their femoral neck fracture. Lifestyle factors and other non-trauma-related risk factors appear to have been important contributors to the occurrence of femoral neck fracture in both age groups.

Increased mortality after lower extremity fractures in patients <65 years of age

“…Al-Ani et al. (2013) found that the majority of these patients had at least one risk factor for fracture and also low mineral density, although they patients were generally reasonably healthy. We therefore hypothesize that the higher mortality observed in patients less than 65 years of age with proximal fractures might be due different factors, such as a risky lifestyle and substance abuse (Levy et al.…”

High failure rate after internal fixation and beneficial outcome after arthroplasty in treatment of displaced femoral neck fractures in patients between 55 and 70 years

“… 2011 , Al-Ani et al. 2013 ). However, closed reduction and IF for patients under 60 years of age is usually recommended as many surgeons are reluctant to replace a native hip joint with an arthroplasty (Bhandari et al.…”

Complications after surgical treatment of femoral neck fractures in men with alcohol dependence syndrome: retrospective register analysis of 154 cases

“…Although the overall hip fracture incidence has not changed in the last two decades, in the last 5 years, the incidence has remained stable in women but increased in men [8]. A recent article [9] stated that a small portion of femoral neck fractures in young adults are caused by highenergy trauma, while lifestyle factors and other nontraumarelated risk factors are major contributors. Several authors from different countries have reported high rates of alcohol consumption in younger patients with hip fracture [10], but we have not identified any reports with incidences as high as those in our study.…”